Peggy Fikac, Houston Chronicle
AUSTIN – More than 1,000 people rallied Tuesday at the Capitol urging Gov. Rick Perry and lawmakers to expand Medicaid, while inside, decision-makers confronted the political nature of the battle as they discussed ways to provide health care coverage to more Texans.

“I think the Obama administration is really looking to help us out. I think they know he (Perry) is not going to capitulate” if it implemented the program, said Sen. Bob Deuell, R-Greenville. Republicans have talked about co-pays and deductibles, managed-care expansion and incentives for private-insurance coverage.

Deuell wrote to Perry last week, suggesting the state ask for a block grant that would allow private insurance assistance for Texans eligible for coverage under Medicaid expansion.

Asked about Deuell’s proposal, Perry spokeswoman Lucy Nashed said, “The governor absolutely agrees Texas should have the flexibility to determine and implement a program that best fits the needs of Texans. He’s been saying that for years, but he’s not interested expanding a program that is unsustainable and broken. Simply adding more people and taxpayer dollars to the current system will do nothing to improve access to health care. He’ll continue working with lawmakers on this.”

Rep. John Zerwas, a Simonton Republican who oversees human services issues on the House Appropriations Committee, said he liked Deuell’s idea but suggested it could be “a stretch” for the federal government to negotiate at that level.

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Medicaid expansion targets uninsured, low-income adults who are not part of the traditional Medicaid program. Advocates estimate that from 2014 to 2023, that would mean an additional $100 billion in federal Medicaid money for Texas, matched with a maximum of $15 billion from the state.

For uninsured Texans, health care professionals and advocates who arrived at the Capitol rally Tuesday morning, it boiled down to this chant: “Perry don’t care.”

“All of us are paying more because there are so many people who don’t have insurance. We’re all paying what’s, essentially, an extra tax. For us to say no to Medicaid expansion is just crazy,” said anesthesiologist Dr. Robert Luedecke, of Helotes.

Perry has said he would welcome the flexibility that would come with a Medicaid block grant, but lawmakers acknowledge the idea could be difficult for the federal government to accept.

The House Republican Caucus on Monday voted against Medicaid expansion under the federal health care law in its current form, but it did not close the door to covering more people if given flexibility to do so.

The House Appropriations Committee has set a Friday meeting on Medicaid expansion.

A key selling point of his plan, Deuell said, is that he believes it could cover the million-plus people who would be part of the expansion, but that the state would offer to do so with just half the money – $50 billion over 10 years, rather than $100 billion.(Read more of this story at Chron.com)